Provider Demographics
NPI:1417935214
Name:CAHILL, TERESA R (MD)
Entity Type:Individual
Prefix:
First Name:TERESA
Middle Name:R
Last Name:CAHILL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 66799
Mailing Address - Street 2:NEWTON WELLESLEY RADIOLOGY ASSOCIATES
Mailing Address - City:FALMOUTH
Mailing Address - State:ME
Mailing Address - Zip Code:04105-6799
Mailing Address - Country:US
Mailing Address - Phone:207-347-7423
Mailing Address - Fax:
Practice Address - Street 1:2014 WASHINGTON ST
Practice Address - Street 2:NEWTON WELLESLEY RADIOLOGY ASSOCIATES
Practice Address - City:NEWTON LOWER FALLS
Practice Address - State:MA
Practice Address - Zip Code:02462-1607
Practice Address - Country:US
Practice Address - Phone:617-243-6600
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA723592085B0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085B0100XAllopathic & Osteopathic PhysiciansRadiologyBody Imaging
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAJ12171OtherBLUE SHIELD
MA3089321Medicaid
MAJ12171Medicare ID - Type Unspecified
MA3089321Medicaid